A nurse working on a surgical unit is developing a care plan for a client who has paraplegia. The client has an area of nonblanchable erythema over his ischium. Which of the following interventions should the nurse include in the care plan?

Choice A reason: Amputation is not a contraindication for kidney donation, as it does not affect kidney function or surgical risks. Physical disability, if stable, does not preclude donation, so this condition is irrelevant to eligibility, making it incorrect.
Choice B reason: Primary glaucoma does not impact kidney function or donation safety. It is an eye condition unrelated to systemic health risks for donation, so it is not a contraindication, making this an incorrect choice for exclusion.
Choice C reason: Osteoarthritis, if mild, is not a contraindication for kidney donation, as it does not affect renal or surgical outcomes. Severe cases may pose mobility issues, but this is not typical, so it is incorrect as a contraindication.
Choice D reason: Hypertension is a contraindication for kidney donation, as it increases risks of renal damage and cardiovascular complications post-donation. It compromises long-term kidney function, aligning with transplant guidelines, making it the correct condition to identify.

Choice A reason: Explaining the implications of a Do Not Resuscitate (DNR) status ensures the client understands that no CPR or intubation will occur if their condition deteriorates. This supports informed consent and autonomy, clarifying the scope of DNR to prevent misunderstandings. It respects the client’s decision-making capacity, ensuring their wishes align with end-of-life care preferences.
Choice B reason: Placing a “Do Not Resuscitate” sign outside the room breaches confidentiality under HIPAA, risking unauthorized disclosure of sensitive information. DNR status is communicated via medical records or wristbands. This action is inappropriate, as it does not contribute to implementing the client’s wishes and violates privacy standards, making it an incorrect response.
Choice C reason: Obtaining family consent is unnecessary for a competent client’s DNR request, as autonomy rests with the client. If decisionally capable, their wishes override family input. The nurse’s role is to support the client’s decision, not seek family approval, unless the client is incapacitated, which is not indicated, making this action inappropriate.
Choice D reason: Documenting the DNR request in the medical record ensures the care team follows the client’s wishes, preventing unwanted interventions. Accurate documentation communicates code status, supports legal and ethical standards, and ensures continuity of care. This is critical for aligning treatment with the client’s end-of-life preferences, making it a necessary action.